The Purpose of Global Health Security Index
Pandemics have a comprehensive political, social and economic impact on the countries. It can increase the clashes between the countries because of the displacement of the population. It may cause increasing discrimination and raise social tension. In order to prevent this type of pandemic, the countries need to be prepared with healthcare, economically and social aspects. It is needed to assess how much the countries have taken to obtain which country has less health security. It helps the researchers to know which country is lacking in preparedness for pandemics. Two assessments are present that are used to assess global health security. In the current scenario, the Global Health Index and Independent Panel for Pandemic Preparedness review of 28 countries are the two effective assessments performed in different countries. This paper aims to develop a critical comparative evaluation of two assessments on health system pandemic readiness. These types of assessments aim to examine the countries’ health security to prevent pandemics.
1.Purpose of the Global Health Security Index
The main purpose of the Global Health Security Index is to examine and benchmark the security of health and related capabilities in over 195 countries (ghsindex.org, 2022). It aims to bring measurable changes in the security of national health and can improve the outbreaks of disease that may lead to pandemics situation or international level of epidemics (Abbey et al. 2020).
It has four indices that have been evaluated between the countries through identifying total cases, rate of deaths, rate of cases and the total tests that have been conducted. This analysis is based on six aspects of a country such as prevention, diagnosis and reporting, level of risk in the environment, response system and compliance with the international system of international (Abdalla et al., 2021). It is mainly involved to inform the details or results of assessments so that the government can strengthen the target areas and make better policies for continuous sustainability. It ensures the prevention strategies and detection process reduces risks and improves health outcomes (ghsindex.org, 2022).
.In between the gap between the first and second iteration, the Global Health Index has learned lessons from COVID 19 pandemic. The availability of authentic global data for tracking the spread and effect of COVID 19 may enhance the additional studies that have been performed. In 2019 the index did not include that many indicators whereas the 2021 index has involved several indicators (Chang and McAleer 2020).
This index involves 170 individual questions compared with the 140 in 2019. The second iteration has included the new and revised questions on the zoonotic disease spillover events. In this iteration, several questions related to COVID 19 sensitive scoring schemes have been added in the second iteration of the GHS Index (ghsindex.org, 2022). However, the last change is the approach regarding the default weighting scheme. In 2019, GHS Index this default weighting scheme was dependent on the expert weights whereas in 2021 GHS Index used the neutral weights for the default weighting scheme. The experts and this world have understood how to respond and the capabilities of the countries (Ji et al. 2021).
Indices Evaluated by Global Health Security Index
The Independent Panel for Pandemic Preparedness review of 28 countries aims to identify the capability of the countries to fight COVID 19. It has a mission to give an evidence-based way for the upcoming days in order to learn lessons from the past and present countries. COVID 19 has affected each country in the world. This panel has tried to conduct a comparative analysis of 28 countries to examine which countries have performed better and which are the least countries (Jung et al. 2021).
The Independent Panel has collected data by using three complementary methods such as semi-structured interviews with the experts of the country and the written submissions of national governments of the chosen countries about the account of measures implemented for containing COVID 19. The second way of collecting data is the literature review of the policy documents, reports from the public, peer-reviewed papers and articles that have already assessed the countries’ policy responses regarding COVID 19 (Ravi et al. 2020). Data from round table discussions and written consultations have been gathered. It has used these methods analytically and logically to review each report, data and document. Through these methods, the analytical reports have been prepared and published.
The United States of America is one of the countries assessed under the Global Health Index and Independent Panel for Pandemic Preparedness review of 28 countries.
Figure 1: Six aspects of the GHS Index
(Source:ghsindex.org, 2022)
The ongoing pandemic COVID 19 has affected many countries with the ripple effects that have been felt in different industries of the global economy (Singh et al. 2021). The Global Health Index released the first iteration of a detailed assessment in 2019 and benchmarking the 195 countries to diagnose, prevent and make responses to infectious types of disease threats.
This index has used the rank based evaluation where the four indices have been compared between the selected countries, involving the total cases, the total number of deaths, the rate of recovery and the total tests performed (ghsindex.org, 2022). In 2019, the GHS index was performed with a panel of 21 experts from 13 countries (Rose et al. 2021). It has formed a comprehensive framework for assessing the ability of a country to mitigate and avert pandemics. The panel experts of the international level have given scores to each of the 195 countries and categorised them into three categories such as most prepared (above 66.7), more prepared (33.4 to 66.6), and least prepared (0 to 33.3). It is based on the six categories which comprise health system, rapid level response, detection and reporting, compliance with the international norms, and environmental risks. Findings from the analysis can reveal that none of the countries has fully ready for pandemics. However, the United States of America has scored 83.5 which reflects a good score in resisting the pandemics in the assessment of 2019 (Singh et al. 2021).
The US has ranked highest in preparedness as they have a strong prevention strategy and well detection procedure in six areas. As per the GHS Index report, the United States has a great score in early detection as it is scored 98.2 in this category. However, in the ranking of OECD countries, the US has ranked 32nd position. Although in COVID 19, the United States of America has been hit greatly with many cases and mortalities (Sirleaf and Clark 2021). The United States has the highest number of cases of COVID 19 in every million people. The United States has the highest rank in the GHS index but it represents the worst-performing country in the COVID 19 depending on the indicator. In contrast, the countries which have fewer results in the GHS Index have performed well against the COVID 19 and management of COVID 19 (ghsindex.org, 2022).
Factors Considered by Global Health Security Index
In the context of the GHS Index ranking, the bio experts have given the first position to the United States as it has high-quality scientific staff with labs. It has a strategic stockpile of National and emergency distribution and better communication plans. As per Global Health Security Index 2021, the United States of America stands first in overall preparedness for pandemics. In overall assessments of six aspects, the United States of America has the highest preparedness against pandemics or COVID 19 (Tan et al. 2021).
Figure 2: Basics of responses of the countries
(Source: Wu et al. 2021)
The Independent Panel for Pandemic Preparedness and Response has started work in 2020 (theindependentpanel.org, 2022). The World Health Assembly resolution establishes this panel. It aims to provide an authentic and evidence-based path for future generations through learning lessons from the present and past to make sure the countries and global institutions can potentially address the health threats. This independent panel for pandemics has stated that the investment of 14 billion in therapeutics and diagnosis is appreciable in the United States (theindependentpanel.org, 2022). It is also noticed that the United States has approved the early clinical testing needed for the treatment of COVID 19 (Wu et al. 2021).
On the other hand, the United States can secure vaccine doses sufficient to cover almost 200% of its population. This panel has called on the G7 countries that need an immediate commitment to give the 60% of the 19 billion in the US. It is required for therapeutics, diagnostics, and vaccines and can strengthen the health system. In the US, there is a need to create an international pandemic financing arrangement for pandemic preparedness.
Figure 3: Global Health Security Index
(Source: ghsindex.org, 2022)
The United States has deployed the syndrome surveillance that can monitor the cases that achieve the clinical definition of COVID 19 without confirmation through testing. The United States has developed and investigated the uses of technology and social media channels. The mobile testing app is a site locator in the United States which helps to detect the location of the infected person (Wu et al. 2021). In the US, the heads of the states have denied the severity and risk of COVID 19, which fails pandemic response plans. The denial of the pandemic response plans shows the failure of the leadership.
In comparing the GHS index and the Independent Panel of Pandemics Preparedness review of 28 countries, GHS Index has shown more details on preparedness for pandemics in the United States. The GHS Index has explained the availability of zoonotic disease, antimicrobial disease, biosafety, immunisation, supply chain, the strength of the laboratory system and other aspects. It shows the access to communication infrastructure, restrictions on travel and trade or emergency response actions or operations. On the other hand, this review of the Independent Panel Pandemic Preparedness is not given a chart explaining how the United States works in preparedness for pandemics. However, there are many criticisms present. It is argued by Wu et al. (2021) that the global health Security index could not predict the responses to COVID pandemics among the developing countries and organisations for Economic Cooperation. It is stated by Ravi et al. (2020) GHS Index has a discrepancy in ratings as it overestimates some countries and underestimates some preparedness of the countries. However, this GHS Index has given a broad picture that the United States has a strong early detection ability, biological labs and has a good communication plan to fight against pandemics.
Assessments Performed by Global Health Security Index
Although it has been found that the United States was unable to fight against COVID 19, although it has the appropriate facilities which are required to be prepared for fighting against COVID 19, it gives the data-driven foundation for the reinvigorated national and global conversations for the global and national conversations about the method of developing capacities and support the financial, political and social environments that are required for improving the global preparedness for the infectious disease threat. It has measured the capacities of the countries and many countries have remained dangerously unprepared for future pandemics whereas the US has a strong infrastructure and plan to protest pandemics. The GHS Index has reflected the reality of the pandemic preparedness of the US in comparison to the Independent Panel of Pandemic Preparedness Review of 28 countries.
Figure 4: Evaluation of GHS Index
(Source: ghsindex.org, 2022)
For a long decade, the countries have been facing pandemics. Recently COVID 19 has been declared a Health Emergency at the International level by the WHO. The comparative analysis between the countries has addressed the response to the pandemic. In managing the COVID 19 pandemic, different types of compelling narratives have played a vital role in the processes of decision making regarding the mitigation of risk and managing measures for implementation (Haldane et al. 2021). GHS Index is the integrated framework that provides rapid data on the detection, prevention, response and capacity of healthcare. In this assessment, more than 80 experienced field-based researchers have been involved in the team to assess the six aspects of each of 195 countries. In IPPPR of 28 countries, the health service delivery, governance and financing and the health workforce have been assessed within the community engagement. It has reviewed the responses of 28 countries by using the health resilience framework (Haldane et al. 2021).
Figure 5: Health resilience framework for 28 countries
(Source: Haldane et al. 2021)
In IPPPR of 28 countries, the efforts of tackling the misinformation of COVID 19 are assessed under this review. The members of this panel have spent the past eight months examining the countries’ preparedness. In this review, the researchers conducted semi-structured interviews with the health experts, making a roundtable where they have discussed and gathered data from peer-reviewed papers or articles (Haldane et al. 2021). It has been assessed that inequality and low-quality lifestyle lead to major effects of pandemics as they have insufficient capacity for mobilising rapidly and coordinating between subnational and national responses (Haldane et al. 2021). However, the response to COVID 19 depends on the controlling strategies and approaches of the government.
Figure 6: GHS Index framework
(Source:ghsindex.org, 2022)
In the GHS Index, the data has been collected from the publicly available information and examined each parameter or requirement which are needed in order to protest the pandemic. It has six aspects that are used to check the countries’ preparedness. It has conducted the research in 195 countries and the findings have been drawn from open source data. The economist impact conducted the research by combining qualitative evaluations, which are publicly accessible.
Independent Panel for Pandemic Preparedness Review
Strength of GHS Index
- The strength of the GHS is the scoring and ranking system which helps the countries to understand how strong they are in fighting pandemics.
- GHS Index involves a robust and informed practitioner type of methodology. It reviews the data from different sources (Rose et al.2021)
- It can harmonise the metrics of global health security.
- This system of the GHS Index has considered biosecurity and biosafety a vital component of global health security (org, 2022).
- GHS Index of 2019 has many issues which have been changed in the 2021 GHS Index
- It also considered the catastrophic threats in the approach
Weakness of the GHS Index
- It is a failure to involve the vital persons who are responsible for the emergency preparedness
- It only accesses or uses the publicly available information so that they can have lack information about the countries (Ravi et al.2020)
- The highest-scoring countries on the GHS Index have performed worst against COVID 19 (org, 2022)
- It has discrepancies between the ranking system and the actual response to the COVID 19 pandemics.
- The members of the GHS Index are not directly involved in preparation for pandemic which means they have lacked in experience
Strength of IPPPR in 28 countries
- It has an open invitation to all to contribute to the program of work
- Researchers, private sectors, the general public and organisations of civil organisations, anyone can contribute to it (org, 2022)
- They have included only 28 countries where they can analyse each country closely
- It has involved the scholars or researchers and working with them (Singh et al. 2019)
- They also met with the nurses, midwives, youth, other staff and other people
- The recommendation that the Independent Panel suggests is evidence-based.
Weakness of IPPPR in 28 countries
- It has not appropriately presented the data of each country
- It has given an overall preparedness of high income and low-income countries (Tan et al.2021)
- It has no specific country-related data about how or which country is doing better
- Through this assessment, it cannot be assessed which country is lacking or doing better
Conclusion
It can be concluded that both of the assessments have identified from their findings that no country can be 100% prepared for future pandemics. It is not sure how the international epidemics come and in which form. It is also identified that the low income poor and backward people or areas or countries are more vulnerable and affected by the pandemics. As they have limited access to healthcare, education, and income opportunities, these people cannot take proper preparation against pandemics. However, both of the assessments have unique features that help health experts to understand which country is lacking in the preparation of prevention of Pandemics. The health experts and governments of the countries can use the information from both assessments to increase the effectiveness of the healthcare system.
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